Survey on clinical teaching by specialists in general practice residency training / 中华全科医师杂志

Objective:To survey the status quo of clinical teaching by specialists in general practice residents training.Methods:Thirty-four general practice residents (14 males and 20 females, aged (27.9±1.8) years) who started standardized training in 2016, 2017 and 2019 in the First Affiliated Hospital of Zhejiang University School of Medicine were selected for interview. The semi-structured and open-ended telephone interviews were conducted 6 months after their completion of residency training. The 1st round of interviews with 12 residents of 2016 and 2017 batches was conducted in March 2020 and 2021 to understand their feelings and suggestions about specialty learning. Based on the interview results, literature review, expert consultation and internal discussion, a new model for specialty teaching was developed and applied for subsequent residency training. The second round of interviews was conducted with 22 residents of 2019 batch on March 2023 to investigate the implementation of the new model.Results:In the first round of interviews, 6 participants felt that the learning of specialty knowledge was not comprehensive enough; although all respondents said that they had received simulator training for the final exam in the specialty rotation, 2 people felt that it was not comprehensive and 2 mentioned that some of the items were not practised on a real person; all 12 respondents felt that there was a certain gap between the types of diseases they encountered in the specialty learning and the real world of work; 10 respondents mentioned that there was insufficient training in the management of chronic non-chronic diseases; 7 out of 9 respondents from primary care institutions mentioned that it was difficult to apply the learned specialty knowledge to real work due to local conditions; 7 respondents mentioned that the content and methods of teaching were inconsistent among different lecturers; and respondents hoped that the surgical training, physical exam training, medication instruction, and the length of outpatient follow-up consultations would be strengthened. In the second round of interviews, the feedback of respondents was more positive than in the first round, there were still problems with the separation of teaching and examination content, and insufficient practical training of skills; 2 respondents from general hospitals mentioned that the teaching of specialties should be further deepened, and 3 respondents from the primary care institutions mentioned that the teaching of treatment and follow-up management should be further strengthened. Twenty-one respondents generally accepted the new specialty teaching model, but said that there were big differences between teachers of different specialties and there were still problems such as insufficient guidance on drug treatment and follow-up.Conclusion:In general practice, residency training specialist teaching does not fully meet the requirements of the actual work of general practitioners, and although it has improved after optimization, there is still much room for improvement.

Research on the core competence evaluation index system of general practice residents based on the outpatient environment / 中华医学教育探索杂志

Objective:To construct the core competence evaluation index system of general practice residents by the Delphi method.Methods:After the literature review of home and abroad and group discussion, the core competence evaluation index system of general practice residents in the outpatient environment was preliminarily developed. On this basis, the index system was determined through two rounds of expert consultation. Excel 2015 and SPSS 26.0 were used for data entry and statistical analysis.Results:The active coefficients of the two rounds of expert consultation were 95.0% (19/20) and 100.0% (19/19) respectively, and the degree of authority of the two rounds of expert consultation was 0.86. An index system consisting of 6 first-level indicators and 28 second-level indicators was determined. The 6 first-level indicators were medical services/patient care, medical knowledge, professionalism, systems-based practice, practice-based learning and improvement, interpersonal communication, and communication skills.Conclusion:This study has constructed a complete and highly reliable core competence evaluation index system of general practice residents based on the outpatient environment, which can provide reference for the cultivation of the outpatient reception ability of general practice residents in the future.

Efficacy and adverse effects of first-line immunotherapy combined with chemotherapy in real world elderly patients with small cell lung cancer / 中华老年医学杂志

Objective:To investigate the efficacy and adverse effects of first-line immunotherapy combined with chemotherapy in elderly patients with small cell lung cancer(SCLC)in population of real world.Methods:A total of 148 elderly SCLC patients(age ≥65 years old)underwent pathological diagnosis were retrospectively analyzed from January 2013 to June 2023.103 patients received chemotherapy(chemotherapy group), and 45 patients received immunotherapy combined with chemotherapy(combination group). Patients were divided into senior group(≥75 years old)and younger group(<75 years old)by age.To compare the efficacy of different regimens in first-line treatment, the expression of programmed death-ligand 1(PD-L1)and tumor mutational burden(TMB)were evaluated.Response evaluation criteria in solid tumors(RECIST)version 1.1 was used to evaluate the efficacy, and common terminology criteria for adverse events(CTCAE)version 4.03 was used to evaluate immune-related adverse.Kaplan-meier and Log-rank test were performed.Cox regression was used in prognostic analysis.Results:The overall response rate(ORR)of the first-line combination group in elderly SCLC patients was 79.1%(34/43), which was higher than that of the chemotherapy group 63.2%(60/95), but the difference did not reach statistical significance( χ2=3.451, P=0.063). ORR was significantly higher in the combination group than in the chemotherapy group for patients in the ≥75-year-old group, 87.5%(7/8) vs.48.6%(17/35), respectively( χ2=4.001, P=0.045). The difference in median progression-free survival time(mPFS)in the combination group compared with the chemotherapy group was not statistically significant in the overall patients(5.43 months vs.6.07 months, P=0.660). The combination group prolonged patients' median overall survival time(mOS)compared with the chemotherapy group, but the difference did not reach statistical significance(13.63 months vs.11.97 months, P=0.205). In patients ≥75 years old, mPFS was lower in the combination group than in the chemotherapy group(2.97 months vs.6.47 months), but mOS was prolonged compared with that in the chemotherapy group(13.50 months vs.11.40 months), and none of the differences reached statistical significance(both P>0.05). The differences in mPFS and mOS between the combination group and the chemotherapy group were not statistically significant in patients <75 years old(both P>0.05). In elderly patients with severe comorbidities, mPFS and mOS were lower in the combination group than in the chemotherapy group(5.40 months vs.7.30 months and 10.70 months vs.12.27 months, both P>0.05). In patients without severe comorbidities, the difference in mPFS between the combination group and the chemotherapy group was not statistically significant( P>0.05), but the mOS was significantly longer in the combination group(20.57 months vs.11.57 months, P=0.054). Elderly SCLC patients had a positive PD-L1 tumor cell positive proportion score(TPS)rate(≥1%)of 23.5%(4/17)and a high TMB(≥9 mut/Mb)expression rate of 69.0%(11/16). The overall incidence of immune-related adverse reactions was 71.0%(32/45), grade 3 or higher 33.3%(15/45), and the most common grade 3 adverse reactions were rash, immune-related pneumonia and malaise. Conclusions:First-line immune-combination chemotherapy improves ORR and mOS over chemotherapy in elderly SCLC patients; mOS benefit of immune-combination chemotherapy is more pronounced in patients ≥75 years of age without severe comorbidities, low PD-L1 positivity and high TMB expression are present in elderly SCLC patients, and immune-related adverse effects are generally manageable in elderly patients.

Construction of a novel carrimycin-producing strain by using CRISPR-Cas9 and ribosome engineering techniques / 生物工程学报

Carrimycin (CAM) is a new antibiotics with isovalerylspiramycins (ISP) as its major components. It is produced by Streptomyces spiramyceticus integrated with a heterogenous 4″-O-isovaleryltransferase gene (ist). However, the present CAM producing strain carries two resistant gene markers, which makes it difficult for further genetic manipulation. In addition, isovalerylation of spiramycin (SP) could be of low efficiency as the ist gene is located far from the SP biosynthesis gene cluster. In this study, ist and its positive regulatory gene acyB2 were inserted into the downstream of orf54 gene neighboring to SP biosynthetic gene cluster in Streptomyces spiramyceticus 1941 by using the CRISPR-Cas9 technique. Two new markerless CAM producing strains, 54IA-1 and 54IA-2, were obtained from the homologous recombination and plasmid drop-out. Interestingly, the yield of ISP in strain 54IA-2 was much higher than that in strain 54IA-1. Quantitative real-time PCR assay showed that the ist, acyB2 and some genes associated with SP biosynthesis exhibited higher expression levels in strain 54IA-2. Subsequently, strain 54IA-2 was subjected to rifampicin (RFP) resistance selection for obtaining high-yield CAM mutants by ribosome engineering. The yield of ISP in mutants resistant to 40 μg/mL RFP increased significantly, with the highest up to 842.9 μg/mL, which was about 6 times higher than that of strain 54IA-2. Analysis of the sequences of the rpoB gene of these 7 mutants revealed that the serine at position 576 was mutated to alanine existed in each sequenced mutant. Among the mutants carrying other missense mutations, strain RFP40-6-8 which carries a mutation of glutamine (424) to leucine showed the highest yield of ISP. In conclusion, two markerless novel CAM producing strains, 54IA-1 and 54IA-2, were successfully developed by using CRISPR-Cas9 technique. Furthermore, a novel CAM high-yielding strain RFP40-6-8 was obtained through ribosome engineering. This study thus demonstrated a useful combinatory approach for improving the production of CAM.

Clinical and epidemiological characteristics of respiratory adenovirus infections in children: analysis of 488 cases / 中华临床感染病杂志

Objective:To investigate the clinical and epidemiological features of acute respiratory adenovirus infection in children.Methods:Clinical data of 488 children with acute respiratory tract human adenovirus (HAdV) infection admitted in Children’s Hospital of Zhejiang University School of Medicine from September 2018 to August 2019 were retrospectively analyzed. Nasopharyngeal swabs or nasopharyngeal aspirates (NPAs) were collected and tested by direct immunofluorescence assay. Kruskal Wallis H test was used for quantitative data without normal distribution, and P<0.05 was considered to be statistically significant. The qualitative data were compared by chi-square test or Fisher’s exact test. Bonfereoni chi-square segmentation was performed for comparison between groups, and P<0.007 was considered statistically significant after correction. Results:A total of 488 HAdV positive cases were detected from 7 072 patients with acute respiratory tract infection (6.9%), including 305 males (62.5%) and 183 females (37.5%). The median age of HAdV positive children was 43 months (39 days to 12 years). The detection rate in 6 m-<2 y age group(8.7%, 123/1 408)was significantly higher than those in <6 m group (3.0%, 6/197)and ≥5 y group(4.6%, 89/1 948)( χ2=7.57, 23.98, P all <0.007). The detection rate in 2-<5 y group(7.7%, 270/3 519)was significantly higher than those in <6 m group and ≥5 y group ( χ2=5.809, 19.688, P all <0.007). The peak rate was detected in the winter [12.9%(238/1 840)] which was significantly higher than those in spring (4.7%), summer (3.9%), and autumn(5.5%)( χ2=103.477, 58.986 and 49.926, P<0.007). The average length of hospital stay was (6±4)d(1-41 d). 486 cases (99.5%) were discharged from hospital after treatment, and 2 cases died. There were 111 cases (22.7%) of acute upper respiratory tract infection, 34 cases (7.0%) of bronchitis and 343 cases (70.3%) of pneumonia; and severe pneumonia was diagnosed in 86 cases (25.1%, 86/343). The common clinical manifestations were fever 93.4% (456/488), cough 94.7% (462/488), wheezing 26.2% (128/488) and shortness of breath 14.8% (72/488). 138 cases (28.3%) had extrapulmonary symptoms, 78 cases (16.0%) had underlying diseases, among which congenital heart disease was most common (16, 3.3%). The average duration of fever was(8.8±2.4)d(5-17 d)in 456 fever cases, the duration between 7-10 d in 277 cases and >10 d in 96 cases; and 439 cases had hyperpyrexia(≥39 ℃). The single infection occurred in 275 (56.4%) cases and mixed infection in 213(43.6%) cases. The proportions of fever, hyperpyrexia, fever duration >10 d, severe pneumonia, wheezing and length of hospital stay in mixed infection group were significantly higher than those in the single infection group ( χ2/ Z=11.960, 6.494, 37.209, 72.841 and -8.805, P all <0.05). The length of hospital stay, proportion of fever time>10 d, wheezing, shortness of breath, hypersomnia/poor spirits, serous effusion, extrapulmonary symptoms, mixed infection, and underlying diseases in severe pneumonia group were significantly higher than those in the mild pneumonia group ( χ2/ Z=-9.182, 23.825, 49.094, 143.627, 219.659, 81.327, 8.080, 21.546 and 10.556, P all <0.05). The proportion of severe pneumonia in 6 m to <2 y group was higher than that in 2-<5 y group and ≥5 y group( χ2=20.709, 8.603, P all <0.007). Conclusions:HAdV is an important pathogen of acute respiratory infection in children. HAdV infection occurs mainly in children aged from 6 month to 2 years and has a high detection rate in winter. Children aged 6 months to 2 years with wheezing, shortness of breath, underlying diseases, extrapulmonary symptoms and mixed infections are more likely to develop severe pneumonia.

Optimization of Extraction Technology of Total Triterpenes from the Leaves of Cornus officinalis by Box-Behnken Design-response Surface Methodology / 中国药房

OBJECTIVE：To optimize the extraction technology for total triterpenes from the leaves of Cornus officinalis . METHODS：Based on the full swelling of the leaves of C. officinalis ，total triterpenes was extracted with heating reflux method. The effects of ethanol concentration ，liquid-solid ratio ，extraction time and extraction times on the contents of total triterpenes from the leaves of C. officinalis were investigated by single factor test. Using oleanolic acid as control ，the contents of total triterpenes were detected by UV spectrometry. On the basis of single factor test ，fixing the times of extraction a s 3 times，taking the contents of total triterpenes as response value ，using ethanol volume fraction ，solid-liquid ratio and extraction time as factors ， Box-Behnken design-response methodology was used to optimize the extraction technology of total triterpenes from the leaves of C. officinalis，and the optimized extraction technology was validated. RESULTS ：The optimal extraction technology of total triterpenes from the leaves of C. officinalis were as follows as ethanol concentration of 73％，liquid-to-material ratio of 38 ∶ 1（mL/g）， extraction time of 60 min. Results of 3 validation tests showed that the contents of total triterpenes from the leaves of C. officinalis were 6.92％，6.91％，6.84％；the average content was 6.89％（RSD＝0.63％），relative error of which with the predicted value （7.28％）was 5.36％. CONCLUSIONS ：The optimized technology is stable and reliable ，and can be used for the extraction of total triterpenes from leaves of C. officinalis .

Practice and exploration of the model of general practice alliance in general hospital / 中华全科医师杂志

The article introduces the implementation of the general practice alliance model in the First Affiliated Hospital of Zhejiang University School of Medicine. Based on the high-quality resources of a tertiary university hospital the general practice alliance has upgraded the clinical, research and teaching abilities of primary care and promoted "two-way referral" system. Our experience shows that the alliance would improve the effectiveness of health care system and facilitate to form a rational medical service ecosystem.

Practice and exploration of the model of general practice alliance in general hospital / 中华全科医师杂志

The article introduces the implementation of the general practice alliance model in the First Affiliated Hospital of Zhejiang University School of Medicine. Based on the high-quality resources of a tertiary university hospital the general practice alliance has upgraded the clinical, research and teaching abilities of primary care and promoted "two-way referral" system. Our experience shows that the alliance would improve the effectiveness of health care system and facilitate to form a rational medical service ecosystem.

Mechanism and research status of hemoperfusion in endotoxemia treatment / 国际生物医学工程杂志

Endotoxemia is a pathophysiological manifestation caused by the release of large amounts of endotoxin from bacteria in the blood or in the lesion. It can cause multiple organ failure, irreversible shock, and even death. The mortality rate of endotoxemiaIt is high. Bacterial endotoxin is the main cause of endotoxemia. At present, there is no safe and effective drug to treat endotoxemia in clinic. Research shows that blood purification can effectively reduce endotoxin level in the blood, then achieve the goal of treatment of endotoxemia. In this paper, the pathogenesis of endotoxemia, the development of hemoperfusion therapy technology, the mechanism and research status of endotoxin adsorption by different hemoperfusion resin were discussed, and the performance and safety requirements of hemoperfusion adsorbent materials for endotoxemia treatment were studied, so as to provide theoretical support for the synthesis of new hemoperfusion adsorption materials for the treatment of endotoxemia.

Mechanism and research status of hemoperfusion in endotoxemia treatment / 国际生物医学工程杂志

Endotoxemia is a pathophysiological manifestation caused by the release of large amounts of endotoxin from bacteria in the blood or in the lesion. It can cause multiple organ failure, irreversible shock, and even death. The mortality rate of endotoxemiaIt is high. Bacterial endotoxin is the main cause of endotoxemia. At present, there is no safe and effective drug to treat endotoxemia in clinic. Research shows that blood purification can effectively reduce endotoxin level in the blood, then achieve the goal of treatment of endotoxemia. In this paper, the pathogenesis of endotoxemia, the development of hemoperfusion therapy technology, the mechanism and research status of endotoxin adsorption by different hemoperfusion resin were discussed, and the performance and safety requirements of hemoperfusion adsorbent materials for endotoxemia treatment were studied, so as to provide theoretical support for the synthesis of new hemoperfusion adsorption materials for the treatment of endotoxemia.

Establishment of patient-centered nursing mode and its effect on stress reaction at peri-operational period and postoperative rehabilitation of emmergency surgical patients / 中国中西医结合急救杂志

Objective To contribute the patient-centered nursing mode and discuss its influence on stress reaction at peri-operational period and postoperative rehabilitation of emmergency surgical patients. Methods A total of 108 emergency surgery patients admitted to Xiangyang No.1 People's Hospital Affiliated of Hubei University of Medicine from January 2014 to January 2017 were enrolled as research subjects, and they were divided into an observation group and a control group according to difference in nursing modes, 54 cases in each group. During the peri-operational period, the patients in control group were given routine nursing mode, while in the observation group, the patients received patient-centered nursing mode. The blood pressure, heart rate and levels of various kinds of hormone (insulin, cortisol, epinephrine) and interleukin-6 (IL-6) before and after intervention were measured; the Hamilton anxiety scale (HAMA) and Hamilton depression scale (HAMD) were used to evaluate the psychological stress changes; after operation, the rate of using analgesics, incidence of postoperative infection, Visual analogue scale (VAS), anus exhaust time, off-bed activity time and sleep quality scale scores were recorded to evaluate the quality of patients' postoperative rehabilitation. Results The diastolic blood pressure, systolic blood pressure, heart rate and levels of insulin, cortisol and IL-6 in two groups before operation and 2 hours after operation were significantly higher than those on admission, while the levels of epinephrine were lower than the level on admission, the degrees of increase or decrease of the observation group were slower than those of the control group, and the changes were more significant at 2 hours after operation [diastolic blood pressure (mmHg, 1 mmHg = 0.133 kPa) was 120.58±13.09 vs. 135.35±15.44, systolic blood pressure (mmHg) was 74.69±10.97 vs. 80.50±11.34, heart rate (bpm) was 83.47±11.64 vs. 92.59±12.00, insulin (mmol/L) was 12.58±1.62 vs. 15.96±1.46, cortisol (μg/L) was 128.72±20.53 vs. 140.47±21.58, epinephrine (ng/L) was 38.96±7.24 vs. 35.25±8.01, IL-6 (ng/L) was 157.64±27.06 vs.183.45±29.37, all P ＜ 0.05]. After interference, the HAMA and HAMD scores of the two groups were significantly lower than those before intervention, and the degree of decrease in the observation group was more obvious (HAMA score: 11.58±2.16 vs. 16.74±2.80, HAMD score: 9.42±2.03 vs. 13.38±2.71, both P ＜ 0.05); the rate of using analgetic [25.93% (14/54) vs. 57.41% (31/54)], incidence of postoperative infection [3.70% (2/54) vs. 16.67% (9/54)], VAS scores (4.63±1.21 vs. 6.87±1.74), anus exhaust time (days: 1.53±0.33 vs. 1.86±0.26), off-bed activity time (days: 1.57±0.19 vs. 1.72±0.24) and sleep quality scale scores (5.84±2.07 vs. 9.33±2.39) in observation group were significantly less than those in control group (all P ＜ 0.05). Conclusion The contribution and application of patient-centered nursing mode in treating emmergency surgery patients during peri-operational period is helpful to ameliorate the patients' degree of physiological and psychological stress reactions, and this mode has important significance in promoting the quality of patients' postoperative rehabilitation.

Interview skills for first visit patient in general practice clinic / 中华全科医师杂志

The patients encountered in general practice clinic often are the first visit patients with complex symptoms and uncertain etiology.The interview skill is crucial for effectively obtaining the medical history and thoughts of patient,based of which the correct diagnosis and proper treatment can be made.This article briefly discusses the interview mode and skills in general practice.

Application of GP-IP teaching model in general practice residency training / 中华全科医师杂志

The unique concept,characteristics and service contents of general practice make its residency training to focus on outpatient teaching.General Practitioner Inquiry-Preceptor (GP-IP) is an outpatient teaching mode developed in the general practice residency training base of our hospital.The GP-IP teaching mode includes four modules:diagnosis and treatment package for medically unexplained physical symptoms,Pendleton and RICE inquiry model,video teaching and problem based learning.

Impact of sports activity tracking APP on physical fitness of college students / 中国学校卫生

Objective@#To explore the impact of using sports activity tracking APP data recording and social fitness activities on physical and mental health of college students, and to provide theoretical support for using APP to participate in fitness.@*Methods@#A total of 96 students from Xi an International Studies University and Northwest University were recruited and divided into the control group(35 students), the recording group (29 students)and the interactive group(32 students) by using random number table. The recording group and the interactive group used APP for 12 weeks of exercise intervention, while the control group receive no intervention. For any intervention, participants received physical fitness tests before and after the intervention.@*Results@#After the intervention, sit and reach [(19.36±4.55)cm], lung vital capacity [(2 929.93±422.52)mL], sit ups for 1 minute(39.71±8.32) times, standing long jump [(165.14±14.73)cm] in girls of the recording group significantly increased compared with pre intervention [(16.39±6.15)cm, (2 690.93±380.45)mL, (36.14±9.53) times, (157.64±14.93)cm]( t =-3.34,-2.82,-3.52,-4.55, P < 0.05 ), and the BMI of boys[(22.79±2.18)(22.19±2.22)km/m 2] significantly decreased, and pull up of boys[3.50(2.00,4.75), 4.50 (3.25,9.25)times] significantly increased( t=3.90,Z=-2.04,P <0.05). After the intervention, sit and reach and pull up of boys in the interacticve group [(13.08±2.23)cm,6.00(0.00,12.00)times], and sit and reach [(21.43±5.14)cm], lung vital capacity [(3 259.33±562.70)mL], standing long jump [(171.83±19.17)cm] among girls in the interactive group was significantly higher than that before the intervention [(9.78±3.96)cm, 1.00(0.00,7.50)tims, (18.86±6.26)cm, (2 870.94±429.62)mL, ( 162.78 ±17.20)cm] ( t/Z =-4.22,-2.02,-3.43,-2.68,-3.84, P <0.05). After the intervention, compared with the control group, lung vital capacity and standing long jump scores of boys in the recording group were significantly improved, while the scores of sit ups for 1 minute in girls were significantly improved; sit and reach and standing long jump performance of boys in the interactive group were significantly improved; sit and reach and lung vital capacity among girls in the interactive group were significantly improved( P <0.05). Boys in the interactive group showed a significant improvement in sit and reach compared to the recording group ( P <0.05).@*Conclusion@#Using sports activity tracking APP can effectively improve students physical fitness, can promote student participation and persistence in physical activity.

Preparation and application of layered osteochondral composite scaffold in the repair of articular cartilage defects / 中国组织工程研究

BACKGROUND:Ideal osteochondral tissue-engineered scaffolds should be able to mimic the normal structure ofhuman articular cartilage. OBJECTIVE:To prepare a layered osteochondral composite scaffold based on the anatomical and physiological functions of osteochondral articular cartilage and to observe its repair effect on osteochondral defects in rabbits. METHODS:The poly (lactide-glycolide acid)/β-tricalcium phosphate organic solution was sprayed on the surface of cartilage scaffold using rapid prototyping technology. The layered osteochondral composite scaffold was formed by the“dissolving-adhesion”process. Sixty rabbits were enrol ed, modeled into left knee articular cartilage defects, and then randomly divided into three groups. The layered osteochondral composite scaffold and cartilage scaffold were implanted into experimental and control groups, respectively. Those without any treatment served as controls. Gross and histological observations of the defect region were performed at 12 and 24 weeks after implantation. RESULTS AND CONCLUSION:Gross observation:At 12 weeks after implantation, the defects in the control group were obvious and not repaired at al;the 24-week defect area was decreased, covered by newly formed tissues, but with rough surface. In the experimental group, the defect surface was flat after 12 weeks of implantation, the texture was soft, and the boundary with the surrounding tissues was unclear;at 24 weeks, the defect was covered with transparent cartilaginous tissues and the surface was smooth. Histological observation:At 12 weeks after implantation, the irregular cal us appeared in the control group, but the trabeculae were not formed;in the experimental group, the thickness of the new cartilage was similar with that of the normal cartilage and there was irregular trabecular bone under the cartilage. After 24 weeks of implantation, there were new tissues in the control group, but the thickness was irregular and uneven and the trabecular structure was irregular;while the cartilage surface was smooth and repaired wel in the experimental group. In contrast, repair effect in the control group was poor as assessed by gross and histological observations. These results show that the layered composite scaffold holds a similar structure with human articular cartilage and can promote the repair of articular cartilage defects.

Effects of zoledronate on CaMKⅡ δ and down-stream gene expressions during osteoclast differentiation / 重庆医学

Objective To study the effect of zoledronate (ZOL) on Ca2+/calmodulin-dependent kinase Ⅱ δ (CaMK Ⅱ δ) and down-stream gene expressions during osteoclast differentiation.Methods Mouse osteoclast precursors RAW264.7 cells were divided into the control group and ZOL group.The cells in both groups were induced with 50μg/L receptor activator of nuclear factor kappa B ligand (RANKL) and were harvested on 5 d,while the cells in ZOL group were also simultaneously treated with 1 × 10-6 mol/L ZOL for 2 d.Five days later,the cells were harvested and examined osteoclastogenesis,as well as gene expressions of CaMK Ⅱ δ,nuclear factor of activated T-cells cytoplasmic 1 (NFATc1),tartrate-resistant acid phosphatase (TRAP) and cell-sarcoma receptor coactivator (c-Src).Results The number of TRAP positive multinuclear osteoclasts,number and size of dentin absorption lacunae and area in the ZOL group were (20.0±3.2),(18.0±4.2) and (6 335.3± 1 043.2)μm2 respectively,which were significantly lower than (36.0 ± 8.4),(37.2 ± 5.0) and (11 636.2 ± 3 661.1) μm2 in the control group and decreased by 44.4 ％,51.6 ％ and 45.6 ％ respectively (P＜0.01).ZOL also significantly inhibited the gene expressions of CaMK Ⅱ δ,NFATc1,TRAP and c-Src,and the mRNA levels of these genes were decreased by 44.1％,49.0％,53.8％ and 49.6％ respectively,the protein level were decreased by 43.5 ％,32.2 ％,45.5 ％ and 48.0 ％ respectively.The immunofluorescent cytochemistry detection results showed the fluorescence intensity of CaMK Ⅱ δ,NFATc1,TRAP and c-Srcin in the ZOL group was significantly weakened when compared with the control group.Conclusion ZOL could significantly inhibit the osteoclast formation and bone absorption function,and down-regulates gene expressions of CaMK Ⅱ δ,NFATc1,TRAP and c-Src in osteoclast differentiation.

Dysfunction of visual spatial attention in occipital stroke patients with hemianopia during the acute phase / 中华神经科杂志

Objective To investigate the visual spatial attention of occipital stroke patients with hemianopia during the acute phase.Methods Eight occipital stroke patients with homonymous hemianopia of left side in the acute stage and 10 age-matched healthy controls were recruited to examine the capability of visual spatial attention.The cue-target paradigms were applied in this behavioral research.Results In the repeated measures analysis of variance,the difference of group and cue range had distinct main effect in reaction time and accuracy rate,while the difference of target location only had main effect in reaction time.Compared with the control group,the patients exhibited longer reaction time ((1 628.26 ± 183.97) ms vs (839.79±61.29) ms,F(1,16) =163.706,P＜0.05) and lower accuracy rate (73.40％ ±3.12％ vs 92.99％ ±0.76％,F(1,16) =371.850,P ＜ 0.05).The patients displayed lower accuracy rate under large cue than small cue (71.38％ ±3.35％ vs 75.42％ ±4.23％,F(1,7) =6.706,P ＜0.05),while that of healthy controls did not vary under different cue range(93.01％ ± 0.50％ vs 92.96％ ± 1.42％,F(1,9) =0.010,P ＞ 0.05).The patients showed longer reaction time in blind-side target than healthy-side target ((1 664.17±196.57) msvs (1 594.35±174.45) ms,F(1,7) =14.157,P＜0.05),while that of control group in two target location had no statistically significant difference ((839.67 ± 60.41) ms vs (839.91 ±73.54) ms,F(1,9) =0.000,P ＞0.05).Furthermore,the mean reaction time of stroke patients had a negative correlation with the binocular vision field index (r =-0.824,P ＜ 0.05).Conclusions The extent of vision field loss in occipital stroke patients with hemianopia can reflect impairment of visual spatial attention during the acute phase.The rehabilitation training should emphasize promoting recovery of visual spatial attention in the blind side under large cue.

Expression profiles of CaMKIIδat different stages of osteoclast differenti-ation / 中国病理生理杂志

[ ABSTRACT] AIM:To study the expression profiles and the role of Ca 2+/calmodulin-dependent kinase II delta ( CaMKIIδ) during osteoclast differentiation .METHODS:Mouse RAW264.7 cells were induced by receptor activator of nuclear factor κB ligand ( RANKL) at 50μg/L for osteoclastogenesis .Tartrate-resistant acid phosphatase ( TRAP) staining and bone resorption lacunae examination were performed to verify osteoclast formation .The expression of CaMKIIδat mR-NA and protein levels was also determined by immunofluorescent cytochemistry , RT-qPCR and Western blot at days 0, 1, 3 and 5.RESULTS:TRAP positive multinuclear cells with bone resorption function were formed after 5 d of induction. The mRNA levels of CaMKIIδdetected by RT-qPCR were 1.028 ±0.041, 2.478 ±0.087, 10.524 ±1.284 and 42.914 ± 2.667 at days 0, 1, 3 and 5, respectively, while the protein levels of CaMKIIδ detected by Western blot were 0.762, 0.963, 1.802 and 3.136, respectively.The changes of protein level were also verified by immunofluorescence cytochemis -try, in which the fluorescence intensity increased in a time-dependent manner (P<0.05).CONCLUSION:The expres-sion of CaMKIIδincreases with the differentiation of osteoclasts .CaMKIIδmay play a key role in the osteoclastogenesis .

Comparison of Insecticidal Efficacy of Commonly Used TCM Pesticides and Preliminary Research on Compatibility / 中国中医药信息杂志

Objective To lay the foundation of new botanical pesticides by screening the insecticidal efficacy of 10 commonly used TCM pesticides.Methods Slide immersion method, trace intravenous drip method and insect body dipping method were respectively used to measure contact action of water extract and ethanol extract of the 10 commonly used TCM pesticides toTeranychus cinnbarinus,Brevicoryne brassicaeandMythimna separate, with herbal extracts to three kinds of insect pests of corrected mortality as observation indexes,Results Alcohol extracts for three kinds of insect pests were found to have contact action, and water extracts had no obvious effect. The Stemonae Radix alcohol extract had obvious contact action on three kinds of insect pests, and corrected mortality rates were 78.7%, 85.9%, and 96.7%, respectively; ethanol extracts of Angled Bittersweet, Sophorae Flavescentis Radix, Xanthii Fructus and Kansui Radix showed good contact action to Teranychus cinnbarinus,. The volume ratio of compatibility among Angled Bittersweet, Sophorae Flavescentis Radix, Xanthii Fructus and Kansui Radix was 2:1:1.5:1.5:1.5:1.5. The insecticidal activity to Teranychus cinnbarinus, was stronger than extracts of single herbs, and corrected mortality was 96.5%. Alcohol extracts of Stellera, hellebore, white mustard seed, and Xanthii Fructus showed good contact action toBrevicoryne brassicae. When the volume ratio of compatibility among Xanthii Fructus, Stemonae Radix, Stellera, and hellebore was 1:1.5:2:2, the activity toBrevicoryne brassicae increased. and corrected mortality was 93.1%.Conclusion The insecticidal activity will be enhanced after TCM extracts are under compatibility.

Effect of thalidomide on development of bisphosphonate-related osteonecrosis of the jaws in rats / 南方医科大学学报

<p><b>OBJECTIVE</b>To investigate the effect of thalidomide on the development of bisphosphonate-related osteonecrosis of the jaws (BRONJ).</p><p><b>METHODS</b>Thirty-six rats were randomly divided into groups A, B and C, and treated with saline, zoledronate and zoledronate plus thalidomide, respectively. Three weeks later, the left maxillary first molars of the rats were extracted. Four and eight weeks after tooth extraction, samples were harvested for evaluation of osteonecrosis of the jaws, microvessel density, and cell apoptosis.</p><p><b>RESULTS</b>At both of the time points, no exposed dead bone was observed at the extraction socket areas in the rats except for some small fistulas in groups B and C. Histological examination confirmed the absence of dead bone in group A, whereas small areas of dead bone were observed around the extraction socket in groups B and C. Compared with those in group A, the percentage of empty lacunae and the area of dead bone were significantly increased (P<0.01), whereas bone lacunae density was significantly decreased (P<0.01) in groups B and C at both time points. Microvessel density in groups B and C were also significantly decreased (P<0.01) by 25.87% and 55.27% at week 4, and by 45.62% and 72.84% at week 8, respectively; the apoptotic cells in groups B and C increased by 54.80% and 87.89% at week 4 (P<0.01), and by 208.08% and 250.58% at week 8 (P<0.01), respectively.</p><p><b>CONCLUSION</b>Thalidomide can aggravate zoledronate-induced early-stage BRONJ, and their osteonecrosis-inducing effect of the jaw may be attributed, at least partly, to the inhibition of angiogenesis.</p>